Firearm Violence: A Public Health Problem

In the year since the shootings at Sandy Hook Elementary School in Newtown, more than 11,161 people were killed with a firearm in the U.S., while an estimated69,000 were shot and survived and 20,000 committed suicide with a firearm. Also, at least six other mass shootings — such as the Navy Yard shooting in Washington and a shooting that injured 13 people in Chicago's Back of the Yards neighborhood — were committed.

Although Sandy Hook motivated some states — including New York, Colorado, Louisiana and Connecticut — to pass gun legislation, virtually no movement has occurred federally. We have reached stasis. Gun control proponents called for a ban on assault weapons, high-capacity magazines and allowing people to bring weapons in places ranging from schools to Starbucks. Opponents ratcheted up their call for a more armed and educated citizenry as the way to prevent random shootings.

We were moved by Sandy Hook. Instead of taking sides, we wanted to understand the problem and look for data-driven solutions that could reduce gun injuries, deaths and accidents. We started by designing and teaching a course.

For the past 13 weeks, 30 Yale University students surveyed a broad range of topics related to guns in the United States. Our class studied the mechanics of firearms, the Second Amendment, legal and illegal gun markets, gun crime, gun injuries and suicides, and more. Students pored over survey data, police records and public health information. They even interviewed ordinary gun owners. We broke down data on gun deaths and injuries, and put it back together in an attempt to generate policies that would save lives and prevent injuries.

Incorporating the research and discussion by our students, here is what we came up with:

First, useful and effective solutions to gun fatality and mortality require recognizing the problem as a public health problem, and not just as a crime. A public health approach is pro-active and community-oriented, striving to prevent injuries, deaths and violence by focusing on the long-term and short-term relationships among gun violence, crime and injury. Focusing on gun crime to the exclusion of accidents and suicide impairs our ability to make effective policy — especially policy that benefits children.

Second, no single program, policy or piece of legislation will solve the issue of gun violence, accidents and injuries. Gun injuries do not affect everyone equally. The typical homicide victim in the U.S., for example, is an African American male between 15 and 24, but the typical suicide victim is an older white male. Some strategies more effectively limit accidents and injuries, while others are better suited to addressing gun crime.

Third, the greatest gains in public health come from changing the behavior of the "average" person. It may be easier, for example, to combat obesity by focusing on the eating and exercise of average families as opposed to directing all efforts toward those who are either morbidly obese or severely underweight. Similarly, we should focus on gun policies that affect average Americans and are overwhelming supported by them.

Here are two ways to approach gun violence and safety as a public health problem and that have promise to be effective.

The first entails basic firearm safety education for children. Almost every American knows the phrase "stop, drop, and roll" as a form of fire safety, but no such comprehensive strategy exists for firearms, despite the thousands of tragic accidents annually. Model programs already exist that caution children to "stop, leave the area and tell an adult" should they encounter a firearm. Combined with additional behavior skills training, such programs could go far to ensure the safety of children when they encounter guns.

The second strategy relates to gun crime: Rather than advance sweeping policies aimed at increasing penalties unilaterally, mounting evidence suggests that targeted and specific policing strategies can dramatically reduce gun crime. Those who participate in gun violence, whether offenders or victims, are very concentrated even within high crime areas. One recent study of Chicago shows that more than 40 percent of all gun homicides occurred within a network of 3,100 people, roughly 4 percent of the community's population. The study makes clear that gun violence spreads through this small group much like a blood borne pathogen like HIV. Reductions in gun homicide might best result from directing enforcement and services toward those at highest risk of killing or being killed, rather than deploying non-targeted blunderbuss strategies such as mass stop and frisk.

These two policy initiatives may seem small, but even small adjustments to mean behavior can have large impacts.

Andrew Papachristos is an associate professor of sociology, public health and law at Yale University. Tracey Meares is the Walton Hale Hamilton Professor of Law at Yale University Law School. Contributing students were enrolled in the "Guns in The United States" course at Yale.